qualitative exploration of the nature of grief …

OMEGA, Vol. 55(1) 27-56, 2007

QUALITATIVE EXPLORATION OF THE NATURE OF

GRIEF-RELATED BELIEFS AND EXPECTATIONS*

BETH M. COSTA

LESLEY HALL

JAN STEWART

Deakin University, Australia

ABSTRACT

Societal expectations of grief impact the experience of bereavement. The

congruence of societal expectations with current scientific understanding of

grief is unknown. Therefore two qualitative studies explored community

perceptions of grief. In study one, three small focus groups (N = 9) examined

grief-related expectations associated with hypothetical scenarios of bereave-

ment. In study two, the impact of grief-related perceptions on the lived

experience of bereavement for 11 individuals was explored through semi-

structured interviews. Across both studies, elements of a traditional stage

model view of grief were evident, with participants viewing emotional

expression of grief as important. An avoidant coping style in the bereaved

was considered problematic. Findings of study two suggested that grief-

related beliefs may impact the bereavement experience via appraisal of the

grief response and willingness to support bereaved individuals. The studies

suggested that stage model assumptions in the beliefs of the general popula-

tion persist, although there was a recognition of diversity in the grief response.

INTRODUCTION

Positive social interactions are an important resource for coping with bereavement

(Vachon & Stylianos, 1988). More often than not, however, bereaved individuals

receive negative critical and judgmental comments from others in their social

27

� 2007, Baywood Publishing Co., Inc.

*The reseasrch reported in this article was conducted as part of the first author’s Ph.D., supervised by

the second and third authors.

network, which can have a greater impact on coping than positive social

exchanges (e.g., Ingram, Jones, & Smith, 2001; Kaunonen, Tarkka, Paunonen,

& Laippala, 1999). Individuals develop expectations about how others should

react in specific situations, such as bereavement (Miller & Turnbull, 1986;

Wortman & Silver, 1989). These expectations, influenced by the dominant pro-

fessional and cultural discourse on bereavement, may impact the provision of

effective social support to bereaved individuals (Wortman & Silver, 1989). Given

the well documented importance of positive social reactions during bereave-

ment, examining expectations about bereavement is important, as inaccurate

bereavement-related expectations may lead to negative social exchanges.

Within the professional literature, current understanding of bereavement has

changed from a traditional stage model view of grief, as a series of distinct stages,

to an empirically-based view of grief variability. How this shift in understanding

has influenced societal views of bereavement is unknown, as lay perceptions

of bereavement have not been examined. Given the recent shift in thinking

within the professional literature regarding bereavement and, as individual expec-

tations about grief are partly informed by professional understanding, examining

bereavement-related expectations within the community is necessary. The current

research is a first step toward that end.

Traditional Stage Model Perspective

According to the psychoanalytic stage model perspective of grief (Freud, 1917;

Lindemann, 1979; Sanders, 1999), bereavement consists of a uniform series of

distinct stages, ranging from shock, to intense distress, and ending with recovery.

This pattern of grief is commonly termed a “normal” grief response.1 Failure

to move through these stages in a timely fashion was viewed as pathological,

and assumed to lead to subsequent physical and/or psychological symptoms.

Wortman and Silver (1989, 2001) identified five fundamental assumptions of

the traditional perspective: a) intense distress or depression is experienced fol-

lowing bereavement; b) working through thoughts and feelings of grief facilitates

resolution of grief; c) making meaning from bereavement is important; d) breaking

down the bond to the deceased person is an important task; and e) recovery

from grief is achievable.

Although the stage model perspective was advanced as a heuristic device to

conceptualize the normal course of the grief response, some people outside the

scientific community have interpreted it as prescriptive of the grief response

(Small, 2001; Stroebe, van den Bout, & Schut, 1994; Wortman & Silver, 1989).

28 / COSTA, HALL AND STEWART

1 The term normal grief is used throughout this article to refer to the traditional conception of

the grief response, advanced by the stage model perspective, of intense distress which diminishes

over time. The original use of the word normal in relation to bereavement is based in the clinical

perspective of grief, which distinguishes between an adaptive grief response and other, maladaptive,

reactions to bereavement.

According to Bonanno and Kaltman (1999), the stage model perspective has

received uncritical acceptance within the bereavement field, and is used as a

framework for working with bereaved individuals. For example, in one study,

an international sample of 77 bereavement practitioners and researchers, from

America, the United Kingdom, Australia, Israel, Canada, South Africa, and other

unspecified countries, endorsed the traditional “normal” view of grief as intense

distress which diminishes over time (Middleton, Moylan, Raphael, Burnett, &

Martinek, 1993).

Recent Empirical Findings

A large body of empirical research on the grief process conducted since 1990

has failed to support the assumptions of the traditional stage model perspective

(e.g., Bonanno & Field, 2001; Carnelly, Wortman, & Kessler, 1999; Davis,

Nolen-Hoeksema, & Larson, 1998; Nolen-Hoeksema, McBride, & Larson, 1997;

Schwartzberg & Janoff-Bulman, 1991). Instead, more recent research suggests

that grief responses are characterized by individual difference (Wortman &

Silver, 2001). Four general patterns of grief have been identified: “normal”

grief (typified by the traditional view), chronic, absent, and delayed grief

patterns. In a selective review of five methodologically rigorous, longitudinal

studies, the assumed “normal” stage model pattern of intense distress which

decreases over time was not found to be a prevalent grief response across studies

(Wortman & Silver, 1993). The occurrence of this “normal” grief response

ranged from 9 to 41% of the samples across the individual studies reviewed,

while alternative grief patterns, such as a low level of distress across both

early and later stages of bereavement (an absent pattern), were more frequently

reported.

The traditional assumptions of grief have been challenged by recent research.

For example, not all bereaved individuals report experiencing intense distress

shortly after bereavement and, in one study, an experience of positive emotion

was reported by a sample of 30 men following their homosexual partners’

AIDS-related death (Stein, Folkman, Trabasso, & Richards, 1997). Furthermore,

actively avoiding thoughts and feelings of grief has been found to lead to posi-

tive adjustment rather than to maladjustment through the first five years after

bereavement (e.g., Bonanno & Field, 2001; Bonanno & Keltner, 1997; Bonanno,

Keltner, Holen, & Horowitz, 1995). Making sense of one’s loss does not appear to

be an important task for all bereaved individuals, nor is it necessarily achieved

by all who seek it (e.g., Davis, Wortman, Lehman, & Silver, 2000; Schwartzberg

& Janoff-Bulman, 1991). Research suggests that, through the grief process, the

bond with a deceased person is sometimes transformed into a symbolic, con-

tinuing relationship (e.g., Silverman, Nickman, & Worden, 1992). Finally, some

individuals do not recover from their grief, but instead, accommodate grief into

their lives (e.g., Rubin, 1996).

GRIEF-RELATED BELIEFS AND EXPECTATIONS / 29

Expectations of Grief and Bereavement

When interacting with another person, we hold specific expectations about

how the other person will behave (Miller & Turnbull, 1986). In relation to

bereavement, individuals hold expectations about how a bereaved individual

should react (Kubitz, Thornton, & Robertson, 1989). Grief-related expectations

may impact interactions with bereaved individuals, as well as their bereavement-

related functioning. If an individual possesses specific and overly rigid expec-

tations about the course of bereavement, based on the stage model of grief, they

may harshly judge an individual whose grief response does not conform to the

“normal” pattern of intense distress which diminishes over time. This may lead to

a negative social interaction. Alternatively, expectancies centered on the current

scientific understanding of grief variability may be associated with a greater

acceptance of bereaved individuals who display different grief patterns. This

more flexible expectation may lead to empathic and supportive interactions with

a bereaved individual. Further, if bereaved individuals hold rigid, inaccurate,

grief-related expectations, they may be self-critical of their own grief response

if it fails to match their expectancies (Wortman & Silver, 1989). This may

exacerbate their bereavement-related distress. For these reasons, examining

expectations of grief is warranted.

Previous research addressing lay perceptions of grief is limited to only one

identified study of 172 university students (Kubitz et al., 1989), in which type of

death, gender of the griever, and intensity of grief, were found to mediate the

attractiveness of hypothetical bereaved individuals. Bereaved men who displayed

a lack of intense grief following both sudden and expected deaths were rated

as more attractive than bereaved men who displayed intense grief symptoms,

regardless of type of death. Among hypothetical bereaved women, a lack of

intense grief following an expected death, and an intense grief response following

a sudden death, were both associated with high attractiveness ratings. While this

study suggested that individuals may hold specific expectations about the grief

response of men and women, it was limited to a young adult sample, and did not

examine expectations of grief in relation to the traditional stage model perspective.

Furthermore, Kubitz et al.’s (1989) study was conducted more than a decade ago

in America. Investigating the extent to which traditional grief work assumptions

have become embedded within contemporary Australian community expectations

of grief was warranted. Further, how individuals’ expectations of grief influence

the experience of bereavement from the perspective of bereaved individuals had

not yet been addressed.

The Current Studies

Although a previous study (Middleton et al., 1993) had examined grief practi-

tioners’ and researchers’ views of the grief response, and had found endorse-

ment of the traditional perspective of grief, research investigating community


expectations of grief was limited to one identified dated study (Kubitz et al.,

1989). Furthermore, the impact of grief-related expectations on the bereavement

experience had yet to be explored. Therefore, the current qualitative research

was undertaken in order to explore a) community expectations of grief among

an Australian sample, for evidence of traditional stage model assumptions of

grief; and b) the impact of grief-related expectations on the lived experience

of bereavement.

An exploratory qualitative approach was selected as the most suitable for the

current studies, as this approach allowed the researcher to elicit in-depth, rich data

regarding the “meaning of social phenomena” (Berg, 2001; Steckler, McLeroy,

Goodman, Bird, & McCormick, 1992). In relation to the bereavement experience,

qualitative methods can uncover the unique meanings different individuals attach

to grief and grieving, and which underlie bereaved individuals’ grief reactions

(Stroebe, Stroebe, & Schut, 2003).

STUDY ONE: COMMUNITY PERCEPTIONS OF GRIEF:

A FOCUS GROUP STUDY

Purpose of the Study

The main aim of study one was to explore perceptions of bereavement, in order

to identify whether, and to what extent, the traditional grief-work perspective of

grief was embedded within societal expectations of bereavement. Study one

qualitatively investigated the beliefs and expectations of different individuals

regarding the process of grief following the death of a significant person.

Method

Study Design

Focus groups were conducted in order to explore a range of different per-

ceptions of grief, and to provide a forum for a discussion around bereavement

issues. The format involved group discussion around four hypothetical scenarios

depicting bereaved individuals manifesting different grieving styles, in addition

to questions related to elements of the grief-work assumptions. The presentation of

hypothetical bereavement scenarios provided a means of tapping relevant beliefs

and expectations based on markers of putatively successful and problematic

grieving, evaluations of different grieving styles, as well as unique grief-related

beliefs associated with different bereavement situations. Four descriptions of

various bereavement situations were presented. For two of the descriptions, two

related bereaved individuals were presented. The scenarios were derived from

descriptions of bereavement situations within the literature, and were designed to

display contrasting grieving styles, of a) an emotional expression with intense

distress, and b) a practical grief expression with avoidant coping. For example:


Two young parents lose their only son. The mother cries night and day,

and has lost all her energy for doing anything. She has a strong need to talk

about their child, how he died, and how she is feeling. The father finds it

difficult to talk about what happened, and finds it uncomfortable when his

wife tries to get him to talk to her. He spends his time building the billy-cart

that he and his son had planned to build together.

The remaining two descriptions depicted a bereaved individual who was charac-

terized as being either overly independent or dependent. Following the presen-

tation of each hypothetical situation, participants were asked to evaluate the

grieving style of the bereaved individuals, and to comment on their evaluation.

Questions used as probes included, “How worried would you be about each

individual in the scenario?” and “What is the best way that each individual in

the scenario could grieve?”

Sample Characteristics

The self-selected sample consisted of 9 participants (7 women, 2 men), aged

between 19 and 62 years of age (M = 36 years, SD = 13.64), who were recruited

via an advertisement placed on university noticeboards and a local council

e-mail discussion list. Previous bereavement experience varied among partici-

pants, and ranged from none to a “lifetime” of grief. Only one individual had

not experienced the death of a significant person in their life. One participant

stated that they had worked in the funeral industry.

Procedure

Three separate focus groups were conducted over a three week period. The

size of the focus groups ranged from two to four participants each. While six to

eight participants are often recommended as the optimum size for focus groups,

a smaller size may be more appropriate when discussing sensitive topics, such

as bereavement (Bloor, Frankland, Thomas, & Robson, 2001). The focus groups

took between one and one and a half hours to complete, and were audio tape

recorded. Prior to the commencement of the group discussions, due to the sensi-

tivity of the research topic, participants were reminded that they could take a

break or terminate their participation at any time. No participant chose to terminate

their participation. At the completion of the discussions, each participant was

provided with a list of local grief support contacts.

Analysis strategy—Following the focus groups, the data were transcribed.

Categories and themes relating to perceptions and expectations of the grief process

were extracted from the data through a thematic analysis. This process was

conducted using NVivo (Qualitative Solutions and Research [QSR], 2002), a

qualitative data analysis computer program. Initially, the data were coded into

14 broad categories identified from the data. Within these broad categories,


specific themes were subsequently identified. The transcripts were read and

reread, during which time the categories and themes were refined. In the final

stage of the analysis, there were eight broad categories related to beliefs and

expectations regarding the bereavement response.

Inter-rater reliability of the data was established by a second researcher, who

was naïve to the aims of the study, independently categorizing a random 20%

of the data. An inter-rater reliability criterion of greater than 80% was achieved.

In the case of disagreement regarding categorization of the data, the matter was

discussed until consensus was reached.

Results

The final categories and themes from the data are presented in Table 1, along

with a frequency count of the number of times each theme was mentioned across

the three focus groups. The first two categories (variability of grief and normal

grief) related to evaluation of the grief response, while the remaining categories

(expression, coping, time, make sense, recover, and circumstances influencing

bereavement) were concerned with specific aspects of the grief process. Each of

the broad categories and the themes within each category are described below.

Category One: Variability of Grief

Theme one: No standard grief experience—Consistent across the group discus-

sions was a perception that grief is an individual personal experience characterized

by variability. In addition, participants acknowledged that there is not a single

best way to experience bereavement:

. . . being of different cultures and backgrounds and personalities, we actually

express ourselves in really a large variety of ways. So that no one particular

way is necessarily going to be right or wrong.

Theme two: Factors contributing to variability—Reasons given for grief varia-

bility included gender, age, and religious background. The quality and length of

the prior relationship with the deceased person were also considered important

influences on the expression of grief.

Theme three: Other people allowing individual expression of grief—Partici-

pants believed that it was important for other people in the support network to

allow a bereaved individual to express grief in their own way, without imposing

expectations.

Category Two: “Normal” Grief Response

There was a high frequency of words relating to a “normal” grief reaction.

For example, there were 18 instances in which the word normal was spoken,

while healthy was mentioned on three occasions, and the words common, natural,


Tab

le1

.C

ate

go

ries

an

dT

hem

es

Rela

ted

toG

riefE

xtr

acte

dfr

om

Th

ree

Fo

cu

sG

rou

ps

(Stu

dy

On

e)

Cate

go

ries

Th

em

es

with

incate

go

ries

Fre

qu

en

cy

co

un

taE

xam

ple

co

mm

en

t

Vari

ab

ility

ofg

rief

“No

rmal”

gri

ef

resp

on

se

Exp

ressio

no

f

gri

ef

Co

pin

g

Tim

e

No

sta

nd

ard

gri

efexp

eri

en

ce

Facto

rsco

ntr

ibu

tin

gto

vari

ab

ility

(e.g

.,

gen

der,

ag

e)

Oth

er

peo

ple

allo

win

gin

div

idu

alexp

ressio

n

(No

tap

plic

ab

le)

Need

toexp

ress

Em

otio

nalexp

ressio

n(e

.g.,

an

ger,

sad

ness)

Male

exp

ressio

n

So

cia

lsu

pp

ort

(fu

nctio

ns,n

eg

atives)

Avo

idan

tco

pin

g(e

.g.,

dela

yed

gri

efp

att

ern

)

Co

ncern

with

tim

e

Gri

evin

gfo

rto

olo

ng

20 6 6

30

15

26

77

37

10 5

Diffe

ren

tp

ath

sfo

revery

on

eto

go

thro

ug

h.

Gen

der

defin

es

ho

ww

eg

rieve

ina

way.

Allo

win

gth

ein

div

idu

alto

do

itth

ew

ay

they

wan

tto

.

No

tth

inkin

gm

uch

ab

ou

tit,th

at

do

esn’t

seem

qu

ite

no

rmal.

Yo

un

eed

tod

oso

meth

ing

.

Inth

isb

igcastle

ofd

esp

air

.

It’s

life,keep

mo

vin

go

n.It

seem

sto

be

am

ore

male

way

ofd

ealin

gw

ith

it.

Ifsh

e’s

tryin

gto

talk

ab

ou

tit,th

en

yeah

,it

seem

s

like

sh

e’s

tryin

gto

wo

rkth

rou

gh

it.

Ju

st

ign

ori

ng

it,ju

st

tryin

gn

ot

tod

ealw

ith

itan

d

pu

sh

itd

ow

n.

As

tim

eg

oes

by

its

gets

easie

r.

Lo

ng

term

,fo

ra

lon

gtim

eit

co

uld

be

ad

an

ger.


Make

sen

se

Reco

very

Cir

cu

msta

nces

influ

en

cin

g

bere

avem

en

t

Fin

din

gb

en

efits

fro

mlo

ss

No

n-r

eco

very

fro

mg

rief

Delib

era

teeffo

rtto

reco

ver

Descri

pto

rso

fg

riefre

co

very

(e.g

.,

acco

mm

od

ate

loss

into

life)

Exp

ecte

dd

eath

Ch

ildd

eath

Late

ad

ulth

oo

db

ere

avem

en

t

13

13 6

20

19

13

16

Th

ere

mig

ht

be

so

me

po

sitiv

es

co

me

ou

to

fit

as

far

as

life

isco

ncern

ed

.

Id

on

’tkn

ow

wh

eth

er

gri

efis

an

yth

ing

,so

meth

ing

that

yo

ug

et

over.

...co

nscio

us

decis

ion

just

tog

et

on

with

livin

g

yo

ur

ow

nlif

ean

dn

ot

gri

evin

gth

ep

ast

exp

eri

en

ce.

Learn

toliv

ew

ith

it.

Mayb

eth

at

gri

efp

rocess

ism

uch

easie

rth

an

if

sh

ew

as

tosu

dd

en

lyd

ie.

Th

ew

ord

reco

ver

just

isn

’tap

pro

pri

ate

Ith

ink

wh

en

it’s

the

death

ofa

ch

ild.

Exp

eri

en

ced

that

stu

ffb

efo

re.S

om

ayb

eh

em

ay

be

alit

tle

bett

er

at

it.

aF

req

uen

cy

co

un

tre

fers

ton

um

ber

oftim

es

each

them

ew

as

men

tio

ned

acro

ss

thre

efo

cu

sg

rou

ps

(N=

9).


and typical were each mentioned twice. For example, one participant commented

that “Not thinking much about it, that doesn’t seem quite normal.”

Category Three: Expression of Grief

Theme one: Need to express—There was a strong belief that it was important

for a bereaved individual to express their thoughts and feelings associated with

grief, rather than ignore or deny them. This need to express one’s grief seemed

to require a deliberate effort on the part of the bereaved individual:

To experience it, to understand it, and to move through it and to work through

it. You need to own it and you need to accept it and hold on to it because it’s

a part of what’s going on.

Theme two: Emotional expression—Participants believed that grief could be

experienced through a range of different emotions, including anger, depression,

sadness, despair, and denial. Expressing emotions, such as by crying, was

perceived as a positive means of working through grief. In contrast, failing to

express emotions was thought to be problematic.

Theme three: Male expression of grief—There was a belief that men had

difficulty confronting and expressing their feelings around grief and loss. Further-

more, men were thought to often consciously repress their emotions, rather than

openly experience them. In contrast, the perspective of a male participant suggests

that men may express their emotions in private. This tendency may be associated

with wanting to embody the public image of men as being strong and as the

protector of others.

There was an acknowledgment that, while men find it difficult to express their

grief emotionally, they may express their emotions in a very physical, practical

way. For example, a father may build a monument to honor his relationship

with his son. However, there was a belief, among some participants, that engaging

in a practical task is merely a way of denying one’s feelings and emotions. Further,

in order to adjust to bereavement, it was felt that an emotional expression of

grief needs to be experienced.

Category Four: Coping with Grief

Theme one: Social support—There was a strong view among participants that

social support is an important resource in coping with bereavement. Social support

was thought to come from many sources, including informal close network

members, such as family, friends, spouses, and neighbors. Additionally, it was

felt that social support could come from less close, more formal networks,

including a counselor, support groups, meals on wheels, and a cleaning lady.

While social support was thought to provide “care” and “comfort” to bereaved

individuals, this was also associated with the assumed importance of verbalizing


one’s thoughts and feelings of grief. Deliberately seeking out social support

was regarded as an indicator that an individual was actively confronting and

working through their grief.

Being able to talk about thoughts and feelings of loss was thought to lead

to a positive bereavement outcome, and ultimately, facilitate resolution of grief.

Participants believed that through social support, a bereaved individual was

“able to recover,” “learn to cope,” and “survive.” In contrast to the benefits of

having others to talk to about one’s grief, a lack of adequate social support was

believed to be “socially isolating,” causing the grief process to be “very difficult,”

and bereaved individuals to “have a hard time” coping.

Some participants indicated a perception that there can be negative aspects

of social support, for both the bereaved individual and for support providers.

Negative responses and callous off-hand comments from others were thought

to be particularly difficult for bereaved individuals.

For some support providers of bereaved individuals, listening to people talk

about their loss, particularly circumstances of the death, was recognized as

difficult. Additionally there seemed to be a view that other people may feel

burdened by a bereaved individual’s need for support.

Theme two: Avoidant coping—There was a perception among the sample that

not thinking about grief, keeping excessively busy, or not showing emotions was

indicative of defensively denying one’s thoughts and feelings of bereavement.

Engaging in avoidant coping strategies was thought to be “dangerous” and

maladaptive to the grief process. There was a strong belief that avoidant coping

would ultimately lead to a physical or psychological manifestation of grief, such

as cancer, or a nervous breakdown:

Walk away from it and put it into the too hard basket and slam the door.

And just leave it there. And it usually catches up with them in one way

shape or form.

Category Five: Time

Theme one: Concern with time—The length of time since bereavement was

considered important when evaluating the coping style of a bereaved individual.

Furthermore, there seemed to be a belief among some participants that time

was an important element of the grief experience. This perception suggests an

expectation of the traditional “normal” grief pattern of intense distress which

diminishes over time.

Theme two: Grieving for too long—Displaying signs of grieving for an

extended period of time was believed to be maladaptive. For example, one

participant offered a specific time which they considered to indicate grieving

for too long:


If it’s six months down the track, and she’s crying every day, then I think

there are real issues there that need to be dealt with.

Category Six: Make Sense of Grief

Some participants indicated a belief that bereavement does not make sense,

and therefore, an individual who experiences the death of a significant person

would find it difficult to come to terms with their loss:

It’s hard to make sense of why a person’s gone and where they’ve gone

and you know, why they’ve gone at that time. Because it’s all this big

mystical unknown.

However, other participants believed that making sense of loss was a very

important aspect of the grief process. These participants seemed to view the

making of sense as coming to an acceptance of loss.

Theme one: Finding benefits from loss—An aspect of making sense of loss,

mentioned in the group discussions, was finding benefit from the bereavement

experience. It was thought that being able to find positives from the situation

facilitated the process of adjustment. Positives that can come out of bereave-

ment included gaining perspective on life, increased religious faith, and making

changes in one’s life.

Category Seven: Recovery

Theme one: Non-recovery from grief—Some participants questioned the ability

to ever recover from grief. Another belief evident in the group discussions was

that recovery from grief was an ideal outcome which not all bereaved people are

able to achieve.

Theme two: Deliberate effort to recover—Other participants seemed to believe

that bereaved individuals need to make a deliberate effort to stop grieving and

recover from their loss.

Theme three: Descriptors of grief recovery—Participants in the group discus-

sions offered different terms to describe grief recovery. Within these descriptions,

there appeared to be two separate perceptions of recovery. The first percep-

tion related to accommodating loss into one’s everyday life, and being trans-

formed by the experience of bereavement—“building it into your life” and “learn

to live with it.”

Other descriptions of recovery seemed to indicate a perception of getting

over grief and returning to pre-bereavement functioning, which is similar to the

traditional grief-work assumption of recovery—“move on,” and “get over it.”


Category Eight: Circumstances Influencing Bereavement

Theme one: Expected death—Expected deaths which occur following a ter-

minal illness were thought to be “easier to accept” and resolve than more sudden

deaths. This was associated with a theme of anticipatory grief; an individual

was thought to begin to grieve for their terminally ill relative before death

had occurred.

Additionally, there was a belief that the circumstance of a terminal illness

would allow an individual to share their experience of grief, and to resolve any

issues within the relationship, with the dying person before their death. For

example, one participant provided a personal account of the impact of an expected

death on their bereavement experience:

My brother died of cancer when he was 48. They had told him at first that

he had six weeks to live and they operated on his bone . . . and he had six

months. But if he died in six weeks, he would have died a healthy 47 year

old. But he died six months later as a very old, frail man. And it was terrible.

But looking back now, we had so much quality time in that six months.

We talked about things. . . . And we just sat and talked, and we talked about

all sorts of stuff. And our parents, and things we had never talked about.

He was just my kid brother. And we never sat and talked. And that was a

really really good time. It was terrible. But looking back now, it’s about

12 years. It was a great time.

Some participants felt that physically supporting a terminally ill relative would

be very difficult to cope with and, in such cases, bereavement would be a relief.

This was expressed as “I can live the rest of my life,” and “a release.”

Theme two: Child death—The experience of grief following the death of a child

was viewed to be especially difficult. Making sense and being able to resolve grief

were believed to be hard to achieve when grieving the loss of a child. Furthermore,

it was expected that a bereaved parent would experience long-term effects of grief.

Participants indicated a belief that when a child dies, particularly a young child,

a parent grieves not only for the child themselves, but also for the loss of the

child’s future and loss of their own future with that child:

Because you’re not only losing the child. You’re losing the child’s future.

Losing what should have been, what’s coming. So that’s, that’s probably

the real grieving. The future that you had with that child.

Theme three: Late adulthood bereavement—Due to their age, older adults

were assumed to have had a greater experience of death and bereavement than

younger people. A few participants believed that because of this greater loss

experience, older adults would cope better with the death of a significant person,

and experience a less intense grief reaction, than a younger person, expressed as;

“Experienced this stuff before. So maybe he may be a little better at it.”


After many years of marriage, it was believed that the death of a spouse would

be extremely distressing and lead to difficulties in bereavement. However, there

appeared to be different beliefs regarding how the current cohort of older men

and women cope with widowhood. For older men, a life-long dependence on

women to provide care was thought to exacerbate the grief reaction. In contrast,

widowhood was viewed as a liberating experience for older women, who were

thought to have been previously restricted by their care-giving role.

DISCUSSION

The aim of study one was to explore the beliefs and expectations individuals

hold regarding the bereavement response, particularly with respect to the extent to

which the traditional grief-work perspective of grief is located within societal

perceptions of grief. The qualitative study generated rich data which contained

evidence of particular grief-related beliefs and expectations.

Consistent with Wortman and Silver (1993), there was a strong awareness,

within the sample, of the variability of the grief response, including the influence

of individual factors, such as gender and age, to this expression of loss. Further-

more, participants acknowledged the negative impact of placing rigid expectations

about the grief process upon a bereaved individual’s grief response. However,

participants simultaneously perceived certain grief responses to be more appro-

priate than others to the bereavement experience. These findings suggest an

expectation, within the current sample, of a set of specific bereavement responses,

which reflect elements of the traditional grief-work perspective.

In relation to making sense of loss and recovering from one’s grief, partici-

pants indicated more flexible beliefs. It was acknowledged that making sense

was not achievable in all bereavement situations. This belief is consistent with

recent findings in the literature (e.g., Davis et al., 2000; Downey et al., 1990;

Schwartzberg & Janoff-Bulman, 1991). For example, Downey et al. report that a

third of the 124 bereaved parents they sampled were unconcerned with finding

meaning from their child’s death, and those bereaved parents experienced less

distress across 18 months of bereavement than parents for whom attributional

concerns were important. Participants in the current study also acknowledged

that a bereaved individual may not recover from their grief. This is supported

by a body of research which suggests the importance of a continued attach-

ment to a lost loved one, at least for some bereaved individuals (e.g., Bonanno

et al., 1999; Silverman et al., 1992). For example, some individuals transform

their relationship with the deceased, incorporating “symbolic, internalized, and

imagined relatedness” in order to maintain an ongoing connection (Shuchter

& Zisook, 1993, p. 34).

While recognizing the variability of the grief response, participants also

believed that emotional expression as a particular way of working through grief,

was an integral stage of the grief response. These beliefs suggest that the grief


process is not viewed in a rigid traditional way, and the views may represent

the beginning of a change in societal perceptions of grief, from a traditional stage

model view to a more flexible view of grief which acknowledges individual

differences.

The traditional grief-work assumption relating to the need to actively work

through grief, by confronting one’s thoughts and feelings associated with loss, was

evident in participants’ perceptions. The expectation of an emotional expression

and verbalization of grief marginalizes other means of working through one’s

grief. Doka and Martin argue that grief can be processed in many different ways,

including physically and cognitively, as well as affectively. A more masculine

approach to bereavement focuses on the engagement of a physical or practical

task associated with the loss (Doka & Martin, 1998). Consistently, participants in

the current study indicated a belief that a practical expression of grief was a way

that men may cope with bereavement. However, it was also perceived that

engagement in a practical expression would not resolve grief, and at some point,

such individuals would need to emotionally articulate their grief.

While having supportive people to turn to was viewed as an important resource

for coping with bereavement, it was also acknowledged by participants that

social support can entail negative experiences. The perception that bereaved

individuals may receive unhelpful comments from others is consistent with

previous research findings (e.g., Lehman, Ellard, & Wortman, 1986; Range &

Calhoun, 1990; Thompson & Range, 1992-1993). Negative social interactions,

such as giving advice, encouraging recovery, and minimizing the bereaved indi-

vidual’s feelings, are reported by a significant proportion of bereaved indi-

viduals across studies. Participants in the current study indicated a belief that

social support providers may have negative experiences when confronted with a

bereaved individual. According to the victimization perspective (Silver, Wortman,

& Crofton, 1990), witnessing another person’s grief may arouse feelings of

anxiety, distress, and helplessness, which, in turn, may inhibit the provision of

effective social support. Further research is necessary to examine social support

from the perspective of the support provider.

According to the traditional view, failing to confront one’s loss, through

avoidant coping strategies, is pathological, and the repressed grief will even-

tually surface in a delayed grief reaction (e.g., Rando, 1984; Worden, 1991). An

expectation of a delayed grief reaction, following a lack of adequate grief-work

was evident among a group of bereavement professionals (Middleton et al.,

1993), as well as the current sample. However, there is a lack of empirical

evidence within the literature for the existence of a delayed grief reaction

(Wortman & Silver, 1989, 2001). In fact, findings from longitudinal studies

(e.g., Bonanno & Field, 2001; Bonanno & Keltner, 1997; Bonanno et al., 1995;

Stein et al., 1997) suggest that engaging in avoidant coping strategies can lead

to a positive outcome, rather than a delayed reaction. Therefore, the identified

belief in the current study, that actively confronting loss-related thoughts and


feelings is a necessary stage of grief, is not supported, and even contradicted by

recent empirical findings.

This study has qualitatively explored the beliefs and expectations held by

a small sample of adults with respect to the bereavement response, following

death of a significant other. Most participants had previously been exposed to

bereavement; only one individual indicated that she had not experienced the

death of a close person in her lifetime, but her responses did not differ from those

of the previously bereaved participants. While most of the sample had previously

experienced bereavement, it is not known whether participants had sought formal

support for their grief from a bereavement practitioner. If they had, it is possible

that exposure to a health professional model of grief may influence the results

and reflect professional, rather than community, perceptions of grief.

Despite an acknowledgment of the variability of grief, some evidence of a

traditional stage-model perspective of bereavement was found in participants’

perceptions, relating to the belief that certain grief responses are more appro-

priate than others during bereavement. This suggests the continued dominance

of empirically unfounded grief-work assumptions within societal perceptions of

grief. Given the preliminary findings of study one, whether, and to what extent,

grief-related perceptions impact the actual experience of bereavement, from the

perspective of bereaved individuals was explored in study two.

STUDY TWO: GRIEF-RELATED EXPECTATIONS AND

THE LIVED EXPERIENCE OF BEREAVEMENT:

A QUALITATIVE INTERVIEW STUDY

Purpose of the Study

Study one identified elements of traditional stage-model assumptions regarding

the process of bereavement within the grief-related perceptions of a small com-

munity sample. Based on these findings, the purpose of study two was to quali-

tatively explore how grief-related beliefs and expectations impact upon the actual

experience of grief, from the perspective of bereaved individuals. Of primary

interest was exploring: a) bereaved individuals’ evaluation of their own grief

response; b) whether individuals’ beliefs and expectations of grief are changed

by the experience of bereavement; and c) the perceived beliefs and expectations

of others in the bereaved individuals’ social environment, embedded in the

comments made or behaviors enacted towards the grieving individual.

Method

Study Design

A semi-structured individual interview format was adopted for this study.

The interview schedule focused on three main areas of interest: participants’


own experience of bereavement and self-evaluation of their grief response, par-

ticipants’ beliefs and expectations of the process of grief, and perceived reactions

of other people to the participants’ grief. Probing questions were used to follow

up any relevant points of interest, for example “Can you tell me more about

that?” and “How did you feel about that?”

Sample Characteristics

The current sample consisted of 11 adults, recruited via an advertisement

printed in three local newspapers, and included nine women and two men. The

current sample was independent of the study one sample. The age of participants

ranged from 41 to 52 years. In the interviews, seven participants discussed a single

bereavement, while two, three, five, and six bereavements were discussed by the

remaining participants. All participants had experienced the death of family

members, including: husband (4), mother (4), wife (2), father (2), siblings (2),

siblings-in-law (2), child (1), and great nephew (1). A range of bereavement

circumstances were discussed, both sudden and expected, and included: cancer,

brain tumor, multiple myeloma, lung infection, pneumonia, stroke, heart attack,

drug overdose, car accident, suicide, and disability-related death. Two participants

had shared caregiving of their relative, prior to their death, while one participant

had been the primary caregiver of her relative before death. The time since

bereavement ranged from one month to 14 years (M = 4.5 years). While the initial

requirement for participation was having had experienced bereavement at least

six months previously, one participant had experienced bereavement only one

month prior to the time of the interview. Due to the nature of the individual’s

recent bereavement experience, which was an expected on-time death, and fol-

lowing a careful discussion with the individual regarding the nature of the

interview questions, it was decided to include the participant in the study.

Procedure

Eleven individual, face-to-face, semi-structured interviews were conducted

over a three month period. Each interview took three quarters of an hour to one

and a half hours to complete. The interviews were audio tape recorded and

subsequently transcribed verbatim. Before the commencement of each interview,

participants were reminded that they could terminate the interview at any point

if participation became too distressing. No participant chose to terminate

their interview.

Analysis strategy—Broad categories were defined a priori, based on the inter-

view questions: grief-related beliefs before bereavement, reaction to own grief

response, grief-related beliefs after bereavement, and reactions of other people

to bereavement. Following transcription, the data were entered into NVivo. A

thematic analysis was conducted. In the first stage of the analysis, the data were


read and reread, and coded according to the four broad pre-defined categories.

Subsequently, the data was re-analyzed and themes within the broad categories

were developed inductively from the data. Following the analysis, a random

sample of 20% of the interview data was independently categorized by a second

researcher who was naïve to the aims of the current study, to establish inter-rater

reliability at greater than 80%.

Results

The final four categories and themes which emerged from the data appear in

Table 2, along with a frequency count of the number of times each theme was

mentioned across the interviews. Each of the categories and themes within each

category will be presented descriptively.

Category One: Grief-Related Beliefs before Bereavement

Participants were asked to reflect on the perceptions of grief which they could

recall having held prior to experiencing a close bereavement.

Theme one: Lack of awareness—Six participants indicated that they didn’t

think about grief and bereavement until it happened to them personally. One

participant echoed the sentiment regarding not wanting to reflect on death and

mortality: “You don’t want to think ahead to that sort of thing really.” Another

participant recalled being curious about what the experience of grief would be like.

Theme two: Naïve beliefs—When reflecting back on their previously held

perceptions of grief, seven participants stated that these were naïve and lacked

a real understanding of what the experience of grief was actually like. This was

exemplified in the comment of one participant:

I had an idea. But compared to what I’ve actually been going through, I had

no idea. I thought, oh yeah, this is what happens and you get over things.

And, nah, it doesn’t really work that way.

Evident in some of the beliefs recalled by participants was an expectation of the

traditional “normal” grief response of intense distress which diminishes over time.

Category Two: Reaction to Own Grief Response

Within participants’ discussions of their own bereavement experience was a

self-evaluative component, which reflected a negative, surprised, or accepting

reaction to their own grief response.

Theme one: Negative reaction—Seven individuals expressed concern regard-

ing their own grief response. Negative self-evaluations were concerned with

time, experiencing too much distress, and experiencing too little distress.


Tab

le2

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ness

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1).


Four individuals who were concerned with time expressed a belief that their

grief symptoms had gone on for too long:

I’m failing grief. Here it is, three years down the track and I still haven’t got it.

The two participants, who expressed a concern about experiencing too much

distress, thought that they shouldn’t feel as distressed as they actually did feel.

One participant negatively compared themself to another individual who had

experienced multiple losses, but was perceived to cope better than the participant.

The second participant believed that, because they had experienced an expected

bereavement, such intense grief as they felt was not warranted.

One participant expressed a belief that they should be more distressed than they

were: “maybe I should be a little more distraught than I am.”

Theme two: Surprise—Two individuals expressed surprise at their grief

response. The first participant indicated that they weren’t prepared for the amount

of distress that they actually felt when their relative died. This participant indi-

cated surprise at their emotional response during the interview, despite it being

14 years since their bereavement. In contrast, a second participant was surprised

that after having experienced multiple bereavements, they were still able to

cope and function in their day to day life.

Theme three: Acceptance—Only one participant expressed an acceptance of

their grief response: “I’ll have a cry and that’s okay.” This participant felt that

being distressed about their grief response was not helpful, and wouldn’t bring

back their deceased relative.

Category Three: Grief-Related Beliefs after Bereavement

Participants were asked about their perceptions of grief at the current time, after

having experienced bereavement. Three changes in grief-related perceptions were

mentioned: increased flexible beliefs regarding the process of grief, increased

philosophical beliefs, and a greater understanding of other bereaved individuals.

Theme one: Flexible beliefs—While the beliefs held by participants prior to

experiencing bereavement seemed to suggest a view of grief as a traditional

“normal” response, the current beliefs of nine participants conveyed a more

flexible perception of the grief process. There was an acknowledgment that

the expression of grief differs between individuals. Additionally, participants’

expanded beliefs reflected their experience that grief doesn’t follow a standard

trajectory:

I feel I’ve developed, yeah, a maturing in understanding that everyone’s

got a different way of grieving. And that it takes different amounts of time

for different people.


Theme two: Philosophical beliefs—Rather than viewing grief as merely a

process of coming to terms with the death of a person, five participants developed

a deeper philosophical understanding of grief through the experience of bereave-

ment. Participants spoke of thinking more about life, gaining a greater awareness

of their mortality, and realizing that life can be unpredictable.

Theme three: Greater understanding of other bereaved individuals—Three

participants reported that their bereavement experience had given them a greater

insight into the experiences of other grieving individuals. One male participant

became more comfortable with outward displays of emotion, and felt better able

to offer sensitive support to grieving individuals, than prior to his own bereave-

ment experience. Another participant was able to understand the behavior of a

grieving relative, which the participant previously found frustrating.

Category Four: Reactions of Other People to Bereavement

It was of interest to examine whether the efforts made by participants’ social

network to provide support to participants matched the needs of the participant in

the time since their bereavement. In order to explore this issue, participants were

asked to discuss the comments or behaviors shown to them by other people, in

relation to their bereavement, by individuals within their social environment, in

the time since experiencing the death of their relative. In particular, participants

were asked to identify the most helpful and the least helpful things other people

had done for them. Reactions of other people fell under two broad themes, positive

and negative reactions.

Theme one: Positive reactions—All but one participant recalled positive

reactions from individuals within their social network following bereavement.

Positive reactions took the form of emotional support, unconditional acceptance,

acknowledging the individual’s loss of the deceased person, and the provision

of practical support.

For seven participants, the receipt of emotional support was helpful for coping

with their grief. Emotional support came via being with the participant in the

first few days after their bereavement, regular phone calls, and being available

when the participant felt like talking. In particular, having close friends and family

who would sit with the bereaved individual and allow them to cry and talk openly

about the deceased relative was an important part of coping with grief for these

participants. The effect of receiving emotional support was to allow the participant

to release their grief so that they would be able to carry on with their daily life.

Emotional support was especially helpful when it came from individuals who

had also experienced bereavement, as they were perceived to understand better

than anyone else what the participant was going through. Individuals who had

previously been through the grief process were able to validate participants’

experiences and feelings. This was extremely powerful for participants. When


participants knew other bereaved individuals, they were able to provide mutual

support to each other.

Five participants indicated that they had experienced acceptance of their grief

response from others. The unconditional acceptance felt by these participants

was embedded in the emotional support they received. For some participants,

acceptance centered on the length of time they grieved, including an acknowledg-

ment that they may continue to grieve for a very long time. For example, one

participant felt that emotional support was still available to them from two

members of their support network, and will continue to be available in the

future, despite the fact that it has been two years since they have experienced

bereavement. Another way participants felt accepted was being allowed to behave

in whichever way they wanted, such as staying away from social events, without

being pressured into doing certain things before they were ready.

For three participants, having their deceased relative honored in stories shared

by other people in their relative’s lives was a helpful way that others could be

supportive. Participants recalled hearing anecdotes from aspects of the deceased’s

life which the participant wasn’t involved in, such as a husband’s working life

or an older parent’s friendships.

The receipt of practical support from others was mentioned by two participants

as helpful in coping with their grief. The offering of food, flowers, and time off

work helped ease some of the day to day demands of these participants during

their grief.

Theme two: Negative reactions—All 11 participants in this study had received

negative reactions in relation to their grief from other people. The four types of

negative reactions mentioned included judgmental comments, lack of support,

insensitive comments, and secondary losses.

Of the negative responses, judgmental comments were the most frequently

discussed, with 10 participants describing instances of receiving such comments.

Judgmental comments from others were perceived as unhelpful and unrealistic.

Judgmental comments often centered on the concept of time, and suggested an

expectation among support members that the bereaved individual should recover

from their grief after a certain amount of time. Participants also mentioned

receiving judgmental comments regarding the amount of distress they displayed.

The implied expectation here was that the bereaved individual should be observed

to publicly express their grief through crying or being visibly distressed: “they all

wait for you to cry in front of them.”

Two participants expressly stated that they were not concerned about the

expectations other people held about their grief response. In contrast, four other

participants reported being concerned about the views of others.

Six participants described instances when individuals close to them had

responded to the participants’ grief with a clear lack of support. This was found

to be hurtful to the bereaved individual, who wanted to be supported.


Participants indicated that a small number of individuals made comments

which were perceived as insensitive and seemed to come from a lack of con-

sideration for the feelings of the bereaved individual. Such comments, received

when the participants were acutely grieving, were distressing, and sometimes

exacerbated their grief.

Four participants, three of whom had suffered the death of a spouse, mentioned

losing friendships through the grief experience. The way in which some indi-

viduals responded to these participants changed after they had experienced

bereavement. Previously close and intimate friendships became less close and

more distant. One participant recalled a friend who failed to return her phone call

after her relative died. The participant hasn’t spoken to the friend since that time.

One participant articulated their belief that their bereavement resulted in lost

friendships because of the threat they posed to other non-bereaved people. This

participant felt that her bereavement confronted others with their own mortality

and that of their loved ones. Perhaps some people have difficulty coping with

that and so break off contact with the bereaved individual. It may also be possible

that individuals within the social network become overwhelmed and burdened

by the bereaved individual’s grief, motivating them to reduce contact with the

bereaved person. Regardless of the reason, participants grieved the loss of their

previously close friendships.

DISCUSSION

The aim of study two was to explore how grief-related expectations may impact

the experience of bereavement, from the perspective of bereaved individuals. Of

specific interest was: bereaved individuals’ self-evaluation of their grief response;

possible changes in bereaved individuals’ grief-related beliefs and expectations

over time; and the perceived grief-related beliefs and expectations of support

network members. In order to explore these three areas, semi-structured individual

interviews were conducted with a small sample of bereaved individuals. The

findings suggested that certain grief-related perceptions may be particularly

relevant to the appraisal of one’s own and others’ bereavement-related coping,

as well as the willingness to provide social support to bereaved individuals.

Specifically, stereotypic or rigid expectations about the bereavement process may

lead to observers making negative judgments of different bereavement responses

and a lack of effective support being provided to grieving individuals.

Perceptions of the Grief Experience

Participants’ current perceptions of grief and bereavement were qualitatively

different from those recalled as existing prior to, and at the time of, bereavement.

Participants felt that before they had experienced the death of a significant

person, their grief-related beliefs were limited and inaccurate; however, these


early perceptions were transformed by the bereavement experience. They recalled

their previous belief that grief involved a sense of sadness which diminished

over time, reflecting a traditional stage model view of grief. It is possible that

before being confronted personally with bereavement, thinking about the grief

process was not a salient concern for participants, and therefore, they may

have relied on dominant societal grief-related beliefs gleaned from such sources

as the media and popular culture. Among the current sample, these findings of

inaccurate perceptions of grief, consistent with a stage model, support those

reported in study one, as well as in Middleton et al.’s (1993) study of bereavement

professionals’ perceptions of grief.

Participants expressed a greater appreciation of the variability of the grief

response, including the belief that grief does not follow a narrowly defined

trajectory of intense distress which diminishes over a limited amount of time.

Thus, the personal experience of bereavement appears to broaden one’s grief-

related perceptions. This finding, of more flexible beliefs following the personal

experience of bereavement, contrasts with the traditional expectations of grief

identified in study one. Within the first study, all but one of the nine participants

had previously experienced the death of at least one close person in their lives.

Despite this, however, a number of grief-related beliefs identified in study one

were found to conform to rigid traditional stage model assumptions of grief. It

is possible that the difference in findings between study one and two may be

due, in part, to the point of reference from which participants thought about

grief. Study one asked participants to consider grief-related beliefs in relation to

hypothetical scenarios of bereavement, while in study two, participants discussed

perceptions of grief in relation to their own personal experience of bereavement.

Thus, when considering grief in general terms, individuals may rely on rigid

stereotypical beliefs prevalent in society. In contrast, when thinking of grief

from a personal perspective, individuals may form unique perceptions of grief,

based on their own experience of bereavement. This possibility requires further

study using larger, more representative samples.

In addition to the development of flexible grief-related perceptions, participants

also spoke about changes in philosophical beliefs, and developing a greater

understanding of, and greater compassion toward, other bereaved individuals.

These changes may be attributable to the experience of personal growth following

bereavement. Personal growth, or finding benefit from a significant loss, has

been documented within the literature as a positive legacy of bereavement

(e.g., Davis et al., 1998; Gamino, Sewell, & Easterling, 2000; Lieberman, 1996;

Tedeschi & Calhoun, 1996).

Self-Evaluation of Personal Grief Responses

The current study supports Wortman and Silver’s (1989) suggestion that a

bereaved individual’s expectations about grief influences how they appraise their


own bereavement experience. Many participants expressed a negative evaluation

of their grief response following a significant bereavement. The limited naïve

perceptions of grief held prior to personally experiencing bereavement may have

contributed to their negative self-evaluation. The critical elements of the grief

response, which concerned the current sample, related to the intensity of distress

they experienced, and the amount of time they had grieved. These elements are

fundamental to the traditional “normal” stage model view of grief, whereby

intense distress is assumed to occur in the early stages of grief, and then diminish

within a limited timeframe (e.g., Raphael, 1983; Worden, 1991). This finding

suggests that expectations about grief which are based on the stage model may

contribute to a negative self-evaluation if one’s grief response does not match

one’s prior expectations. This may exacerbate bereavement-related distress.

Social Support and the Bereaved

According to Vachon and Stylianos (1988), the receipt of positive social

support is one of the most important resources for coping with bereavement.

The current sample readily recalled instances of supportive reactions from those

within their support network, most often in the form of emotional support. This

finding is consistent with two large qualitative questionnaire studies of bereaved

adolescent siblings (Hogan & DeSantis, 1994) and Finnish bereaved spouses

(Kaunonen et al., 1999), which found that the receipt of emotional support was

considered particularly important for bereavement-related adjustment. A

number of quantitative studies provide additional support (e.g., Ingram et al.,

2001; Kanacki, Jones, & Galbraith, 1996; Vanderwerker & Prigerson, 2004).

Vanderwerker and Prigerson (2004), for example, found that adequate perceived

social support assessed at six months following the death of a partner, was

associated with lower levels of depression and complicated grief symptoms at six

months. Furthermore, bereaved individuals who reported adequate social support

six months post-loss also reported a lowered level of complicated grief symptoms

and greater well-being at 11 months post-loss, in comparison to those with

inadequate perceived support.

In study one it was evident that bereaved individuals may sometimes receive

negative responses from others in relation to their bereavement. Consistently, all

of the bereaved participants within study two indicated that they had received

at least some negative and unhelpful comments from other people. Judgmental

comments, the most frequently reported form of negative support, related to the

amount of time participants were grieving, as well as the level of distress they

displayed. The bereaved participants themselves reported being self-critical of

these elements of their own grief process. It is possible that having received

judgmental comments from others caused participants to question their own grief

response. However, it was not possible to ascertain if this was the case, based

on the current small qualitative study. Nevertheless, the perception of receiving


judgmental comments from support network members suggests the existence of

traditional stage model assumptions embedded within the grief-related beliefs of

support network members. Holding inaccurate expectations regarding the process

of grief is likely to contribute to the provision of ineffective and negative support

responses to bereaved individuals (Wortman & Silver, 1989). Despite being

conducted more than a decade ago, the qualitative studies by Lehman et al. (1986),

Range and Calhoun (1990), and Thompson and Range (1992-1993) provide

similar findings of negative support and judgmental comments.

Despite advancement within the scientific literature regarding the variability

of the grief response, there appears to be a continued influence of unfounded

traditional stage-model assumptions of grief among individuals’ perceptions of

the grief process. Results of study two suggest that grief-related expectations can

impact the experience of bereavement via appraisals of the appropriateness of

one’s own and others’ grief responses, availability of positive social support, and

adjustment to bereavement.

General Discussion

The qualitative studies presented in this article have explored the nature of

grief-related beliefs and the impact of such perceptions on the bereavement

experience. These studies suggest that traditional assumptions may still charac-

terize the grief-related expectations which individuals hold. If this is the

case, then support offered to bereaved individuals can sometimes be unhelpful,

leading to a lack of adequate support being provided at a time when it is much

needed. Further, bereaved individuals’ internalization of the traditional stage

model assumptions may exacerbate the bereavement experience. Greater atten-

tion to increasing public awareness of the variability of the grief response

following bereavement may be necessary to combat the dominance of the tradi-

tional stage model perspective of grief. Further, sensitizing people to the types of

support responses which are perceived as most helpful by bereaved individuals

may also be needed.

Studies one and two are limited in several ways. Firstly, they are based on

small samples composed predominantly of women. The expectations identified

in this research may reflect a female perspective of grief, rather than beliefs

held by the general community. Further research based on a larger and more

representative sample of both men and women is necessary before any conclu-

sions can be drawn about the generality of grief-related beliefs. Additionally,

most participants within study one had previously experienced bereavement.

The grief-related beliefs of individuals who have not experienced a significant

bereavement may differ in unknown ways. Recruiting a sample of individuals

who have not experienced bereavement is difficult; even if sampling is restricted

to a younger population, it is likely that at least some individuals in this age

group will have already experienced the death of a close person in their lives.


Further, when recruiting a self-selected sample, individuals who have

previously been bereaved, or who have had some experience with

bereavement, are more interested in participating in bereavement-related

research, compared to those individuals who have had no previous experience

with death and bereavement.

A further limitation within study two relates to participants’ retrospective

recall of the beliefs regarding the process of grief, which they held prior to

experiencing bereavement. The fallibility and reconstructive nature of human

memory renders the recall of past events and cognitions unreliable. The fact that

bereavement can be traumatic may additionally hamper the ability to objectively

recall previous grief-related beliefs. A prospective research design, whereby

individuals’ grief-related beliefs are measured before the experience of bereave-

ment, may be necessary in order to gain an accurate representation of the impact

of bereavement on one’s perceptions of grief and bereavement.

Despite the limitations of studies one and two, this qualitative research

addressed a gap in the existing bereavement literature. While Wortman and Silver

(1989, 2001) first suggested, over 15 years ago, that traditional grief-related

beliefs and expectations may have an adverse impact on bereaved individuals,

research has not previously examined this possibility. The findings of study

one suggest that elements of the traditional stage model perspective of grief

may characterize individuals’ grief-related beliefs. Consistent findings in study

two provided further support, while also suggesting that the grief-related beliefs

held by both a bereaved individual, and a potential support provider, may impact

how an individual’s grief process is appraised, as well as the willingness of

support network members to provide effective support. Given these suggestive

results, further research on the nature of grief-related beliefs in relation to

bereavement is warranted.

ACKNOWLEDGMENTS

The authors wish to thank Dr. Val Clarke for her invaluable comments on an

earlier version of this article. The valuable comments of an anonymous reviewer

are also acknowledged.

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Direct reprint requests to:

Beth M. Costa

School of Psychology

Deakin University, Waterfront Campus

Victoria, Australia, 3220

e-mail: [email protected]


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